Last month, a Canadian research team led by Dr. Mark Ware published the findings of a multicenter study that examined the safety of medical cannabis use among patients with chronic pain. They discovered that patients who used cannabis every day for a year did not experience an increase in serious side effects compared to those who did not use the drug. Additionally, cannabis users exhibited a significant improvement in pain levels and mood, as compared to the control group. Importantly, this was not a randomized study: the pain patients in the cannabis group were self-selected, and most of them were experienced cannabis users who had already realized that cannabis helped them with their pain. Further research would be needed to examine safety and efficacy of cannabis among pain patients who have never used before.
In an interview with the New York Times from earlier this year, Dr. Ware sheds light on some of the unique aspects of clinical research on cannabis. For one thing, as illustrated by the design of the above-described study, cannabis research has not followed the usual “bench-to-clinic” trajectory of translational medicine. Patients themselves (not lab findings) have often been the impetus behind further research on cannabis as treatment, as when the use of cannabis by HIV patients led to the development of Marinol, a cannabis-based drug. Dr. Ware also discusses the reasons why cannabis use is still so under-researched. One major factor is the stigma that accompanies research on cannabis due to its illegal status in many places. In the United States, where cannabis is still listed as a Schedule 1 drug alongside heroin, researchers are faced with restricted access to the drug. He also comments on the lack of standardization in the U.S.: not only do cannabis plants differ from state to state, but medically eligible health conditions vary considerably as well. This presents further challenges for consistent research on the subject. Finally, he makes the point that physicians need to inform themselves about medical cannabis and become more comfortable discussing it with their patients; this way, they will become better-equipped to help patients through the process. “This isn’t going away,” he says.